America’s Drug Problem: A Hidden Epidemic

Prescription opioids and illicit drugs have become incredibly pervasive throughout the U.S., and things are only getting worse. According to the Centers for Disease Control and Prevention (CDC), overdose deaths have increased 137 percent since 2000. Even more shocking is that opioids – which are legal, controlled substances that are often prescribed by doctors – have caused a 200 percent increase in overdose deaths.

The situation is dire. In 2014, more people died from drug overdoses than from vehicle or firearms accidents. To better understand the severity of these numbers, we took a close look at those directly affected by this epidemic. We also examined the underlying issues that contributed to drug abuse.

Overdose statistics were collected from the Centers for Disease Control and Prevention’s WONDER MCD database. Drug overdose deaths were classified using the International Classification of Disease, Tenth Revision (ICD-10), based on the ICD-10 codes T40.1–3, T40.5, T42.4, T43.6, T51.0.

Mapping Fatal Overdoses in America

To get a clear picture of America’s drug use patterns, we mapped out fatal overdose rates by state and substance over a 15-year period. A look at certain demographics reveals that the highest fatality rates for each substance tended to be concentrated in specific regions or states. For men, these rates were high across a wider age range, while female fatality rates for each substance were lower overall and more limited to a particular age bracket.

Alaska had the most fatal alcohol overdoses, averaging nearly 26 deaths per 100K residents. A research study found that a large percentage of the state’s population partakes in dangerous binge drinking behaviors: 20 percent of adults and 12.5 percent of high school students.

Interestingly, the age bracket incurring the most alcohol-related deaths in Alaska was 45 to 54, for both genders; however, women in this age bracket significantly tipped the scales. Alaskan women 45 to 54 died from alcohol at a rate of 20 per 100,000, which is significantly higher than any other female demographic group in the country. The next highest female alcohol fatalities hovered around nearly 6 per 100,000. Men, however, had consistently high fatality rates across the board – averaging 20-40 per 100,000 – with middle-aged men ranking highest.

Women were more likely to fatally overdose on opioids than anything else. Death rates higher than 10 per 100,000 people were present in every age category, with averages doubling per 100,000 people in the 25-34, 35-44, and 45-54 age brackets. Regionally, these deaths were widely distributed, but West Virginia showed high opioid death rates for all female age demographics.

Benzodiazepine-related deaths were also common in West Virginia, for both men and women. Fatality rates ranging from 20-30 per 100,000 people were seen in men and women aged 25-54 years old.

Heroin overdoses were generally most prevalent in New England, particularly in the 25-34 and 35-44 male age demographics. This region also saw a high rate of cocaine overdoses for men, particularly in Rhode Island. Female cocaine deaths, on the other hand, had the highest numbers in the New Mexico area, peaking around 8- 9 per 100,000 in the 35-44 and 45-54 demographics.

Total Overdose Deaths Based on Gender

Overall, our findings showed that more men than women have died as a result of substance abuse.

To better understand this grim phenomenon, we looked at six classifications of drugs – stimulants, alcohol, benzodiazepines, cocaine, heroin, and prescription opioids. Comparing these types of drugs, we looked at the total number of overdose deaths in the U.S. over a 15-year period, factoring gender into each category, to see if men have higher overdose rates across all substances.

In looking at opioids, the drug responsible for the highest overdose rates among both genders, we found that 52,669 women and 96,429 men fatally overdosed. Although it might seem counter-intuitive, more people in America are dying from legal opioid abuse than from illicit drug abuse. According to the National Institute on Drug Abuse, there are a number of contributing factors such as increases in written prescriptions, invested marketing spend by powerful pharmaceutical companies, and patient reliance on prescription medication.

The next leading cause of death for men was cocaine, with roughly 59,900 overdoses. Benzodiazepine accounted for a majority of overdoses among women, with just over 20,200 overdoses. However, across all drug categories, overdose rates were higher among men.

To fully understand the overdose findings per gender, It’s important to explore the underlying elements of substance use and how they impact genders differently. For example, according to the Substance Abuse and Mental Health Services Administration, men have almost twice the rate of substance dependence as women. Additionally, whereas women tend to internalize problems, men often externalize problems, engaging in impulsive behaviors, which lead to greater chances of substance use disorder development.

Overdose Deaths Based on Age

When we looked closely at the number of overdoses based on age group over a 15-year period (1999-2014), we saw an overall increase in deaths for all age groups. The youngest age group, 15-24, went from 320 to 2,735 deaths. The oldest age group, 65-74, went from 16 to 680 deaths.

Middle-aged groups showed increase as follows: those aged 25-34 went from 1,757 to 10,475 deaths; those aged 35-44 went from 4,225 to 10,475 deaths; and those aged 55-64 went from 226 to 7,486 deaths.

The steepest increase in overdose deaths came from those aged 65-74 years – going from 16 deaths in 1999, to 680 deaths in 2014, a 4,150% increase.

It’s most likely that these untimely deaths have to do with chronic pain and unmonitored prescription opioid refills. According to the CDC, the number of painkillers sold in the U.S. has nearly quadrupled since 1999. However, the amount of reported pain hasn’t changed.

Opioid deaths among the elderly may be attributed to biological factors. As the body ages, it loses the ability to effectively clear drugs out of its system. A standard dose of opioids for a younger person could be a fatal overdose for an older individual.

Opioid Deaths Among Seniors

When it comes to opioid abuse and fatal overdoses, seniors are a very vulnerable group. Over a 15-year period, per 100,000 residents, we saw that both senior men and women increasingly fell victim to prescription opioid drug abuse.

Increasingly, doctors are aggressively prescribing opioids to seniors with chronic pain. Although some problems can be managed with alternative treatments, such as acupuncture, exercise, or chiropractic manipulation, many doctors are being taught that the best way to treat older Americans, regardless of the severity of their conditions, is with opioids.

From 1999 to 2014, senior men experienced a 775 percent increase in opioid overdoses, going from 16 to 140 deaths. Senior women, on the other hand, experienced a 1,682 percent change from 1999 to 2014; they went from 11 to 196 deaths.

Although both genders are dying at an alarming rate, senior women are paying a higher price when it comes to this epidemic. Compared with senior men, older women are more likely to suffer from chronic pain and may use opioids longer than men. While men are more apt to seek treatment for opioid abuse, women may feel too ashamed or embarrassed to admit that they need help. Unfortunately, when help does come, it’s sometimes too late.

Preventing Substance Use Disorders and Fatal Overdoses

Many pathways can lead to drug use, including societal influences, previous injuries, and mental illness.Sadly, as we’ve seen from research, many people don’t get the help they need because stigmas surrounding addiction still exist. As we observed over a 15-year period, addiction nor overdoses discriminate by age, gender or geography. That said, we do see higher rates among specific demographics. It’s important to be aware of this information and those who are at higher risks. There are resources available to help people get care before it’s too late.

If you or someone you know is struggling with a substance use disorder, please call 1-888-930-7812 immediately. We understand that every person is different and that prompt treatment is necessary for a full recovery. It is possible to break free from the chains of addiction.

Methodology

Overdose statistics were collected from the Centers for Disease Control and Prevention’s WONDER MCD database. Drug overdose deaths were classified using the International Classification of Disease, Tenth Revision (ICD-10), based on the ICD-10 codes T40.1–3, T40.5, T42.4, T43.6, T51.0.